Provider Demographics
NPI:1114735727
Name:CHAMPION, CAITLYN ELIZABETH ANN (NP)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ELIZABETH ANN
Last Name:CHAMPION
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2627 S LINDEN CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7107
Mailing Address - Country:US
Mailing Address - Phone:720-546-2357
Mailing Address - Fax:
Practice Address - Street 1:9725 E HAMPDEN AVE STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4917
Practice Address - Country:US
Practice Address - Phone:303-736-9697
Practice Address - Fax:720-306-5464
Is Sole Proprietor?:No
Enumeration Date:2024-12-28
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COAPN.1000416363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000239926Medicaid